Child with Diabetes Mnemonic T-DIABETES MISS H-MELLITUS Mnemonic
Child with Diabetes Mnemonic:
The term diabetes mellitus describes diseases of abnormal carbohydrate metabolism that are characterized by hyperglycemia. It is associated with a relative or absolute impairment in insulin secretion, along with varying degrees of peripheral resistance to the action of insulin.
- Type 1 diabetes mellitus is one of the most common chronic diseases in childhood, is caused by insulin deficiency following destruction of the insulin-producing pancreatic beta-cells. It most commonly presents in childhood, but one-fourth of cases are diagnosed in adults. Type 1 diabetes mellitus remains the most common form of diabetes in childhood, accounting for approximately 2/3 of new diagnoses of diabetes in patients ≤19 years of age in the United States, despite the increasing rate of type 2 diabetes mellitus.
- Type 2 Diabetes Mellitus is characterized by insulin resistance leading to increase insulin production by the pancreatic beta-cells. Over time, the insulin secretory capacity of the pancreas becomes unable to overcome insulin resistance, resulting in progressive deterioration of beta-cell function and steady decrease in plasma insulin and subsequently an increase in plasma glucose.’
Having trouble remembering all the important questions that you must ask during your patient encounter, then try this Child with Diabetes Mnemonic T-DIABETES MISS H-MELLITUS Mnemonic for USMLE Step 2 CS.
Physical Examination
- No child will be present during your USMLE Step 2 CS examination encounter.
- Instead of a child, there will be a family member who will either be present in the exam room or will be communicating with you through a phone call [Telehealth (virtual visit) may also be a possibility in the near future].
- You have TWO very important goals here:
- Ask pertinent questions so you can narrow down your differential diagnosis and come up with an appropriate assessment and plan.
- To determine whether the case that is being presented to you is either an emergency or a non-emergency.
- Based on what the case is, you must instruct the family member to either bring their child to the clinic or to take their child to emergency department for further evaluation.
- You may give simple advice such as making sure to monitor the child’s breathing/pulse or attempting oral hydration and monitoring the urine output but NEVER prescribe any medications, especially antibiotics without seeing the patient first.
- Ultimately the child has to be seen soon and you need to determine WHEN and WHERE the family member must take them.
Child with Diabetes Mnemonic T-DIABETES MISS H-MELLITUS Mnemonic
DIFFERENTIAL DIAGNOSIS
- Type 1 Diabetes Mellitus
- Type 2 Diabetes Mellitus
- Cushing’s syndrome [Cushing’s syndrome Mnemonic]
Child with Diabetes Mnemonic T-DIABETES MISS H-MELLITUS Mnemonic
DIAGNOSTIC WORK-UP
- Basic metabolic panel [BMP]: to evaluate renal function as well as blood glucose levels and electrolytes.
- HbA1c
- Urinalysis/Microalbuminuria: to check for the presence of protein in the urine.
- Insulin and C-peptide level
- Islet cell antibodies
- 24 hour urine cortisol to rule out Cushing’s syndrome
Child with Diabetes Mnemonic T-DIABETES MISS H-MELLITUS Mnemonic
- BEST Tips on how to Pass USMLE Step 2 CS
- Physical Exam Videos
- BLUE SHEET Mnemonic (.pdf file)
- CS Timer
- Official USMLE Step 2 CS Site
- Official Content Description & General Information Booklet (includes the list of abbreviation, you can use on your exam)
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Child with Diabetes Mnemonic T-DIABETES MISS H-MELLITUS Mnemonic